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https://www.readbyqxmd.com/read/29677048/criteria-for-diagnosing-primary-aldosteronism-on-the-basis-of-liquid-chromatography-tandem-mass-spectrometry-determinations-of-plasma-aldosterone-concentration
#1
Stephanie Baron, Laurence Amar, Anne-Laure Faucon, Anne Blanchard, Laurence Baffalie, Catherine Faucard, Simon Travers, Jean-Yves Pagny, Michel Azizi, Pascal Houillier
BACKGROUND: Primary aldosteronism is affecting about 10% of hypertensive patients. Primary aldosteronism should be diagnosed by screening tests based on plasma aldosterone concentration (PAC) and aldosterone-to-renin ratio (ARR), followed by confirmatory test. The cutoff values for PAC and ARR depend on PAC and plasma renin measurement methods. Liquid chromatography-tandem mass spectrometry (LC-MS/MS), the new gold standard method for aldosterone determination, is now widespread but shows lower values than immunoassays...
April 19, 2018: Journal of Hypertension
https://www.readbyqxmd.com/read/29616399/techniques-of-adrenal-venous-sampling-in-patients-with-inferior-vena-cava-or-renal-vein-anomalies
#2
Kenji Endo, Satoru Morita, Shingo Suzaki, Hiroshi Yamazaki, Yu Nishina, Shuji Sakai
PURPOSE: To review the techniques and technical success rate of adrenal venous sampling (AVS) in patients with inferior vena cava (IVC) or renal vein anomalies. MATERIALS AND METHODS: The techniques and success rate of AVS in 15 patients with anomalies [8 with double IVC (dIVC), 3 with left IVC (ltIVC), 2 with retroaortic left renal vein (LRV), and 2 with circumaortic LRV] underwent AVS was retrospectively reviewed. RESULTS: Among 11 patients with IVC anomalies, the success rates for sampling the right and left adrenal veins (RAV and LAV) were 81...
April 3, 2018: Japanese Journal of Radiology
https://www.readbyqxmd.com/read/29541836/image-fusion-guidance-with-pre-procedural-ct-with-real-time-fluoroscopy-for-adrenal-venous-sampling
#3
Satoru Morita, Hiroshi Yamazaki, Kenji Endo, Shingo Suzaki, Akira Mitsuhashi, Takafumi Shiohara, Midori Yatabe, Atsuhiro Ichihara, Shuji Sakai
PURPOSE: To assess the effectiveness of image fusion guidance (IF) with pre-procedural computed tomography (CT) with intraprocedural fluoroscopy for adrenal venous sampling (AVS). MATERIALS AND METHODS: AVS before and after ACTH stimulation including bilateral segmental sampling of effluent tributaries was performed in 62 patients with IF. A 3D volume rendering image, including adrenal glands and veins extracted from previously obtained contrast-enhanced CT images, was manually registered to the real-time X-ray fluoroscopy...
March 14, 2018: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29521660/update-in-adrenal-venous-sampling-for-primary-aldosteronism
#4
Gian Paolo Rossi
PURPOSE OF REVIEW: Current guidelines recommend adrenal venous sampling (AVS) to identify the surgically curable causes of hyperaldosteronism. In contrast with this recommendation, AVS remains markedly underutilized in clinical practice, which leads to deny curative adrenalectomy, to many patients with primary aldosteronism. The purpose of this review is to challenge the views that AVS is a technically challenging, invasive and risky procedure, which moreover, is difficult to interpret...
March 7, 2018: Current Opinion in Endocrinology, Diabetes, and Obesity
https://www.readbyqxmd.com/read/29467114/adrenal-venous-sampling-the-learning-curve-of-a-single-interventionalist-with-282-consecutive-procedures
#5
Hugo Jakobsson, Katerina Farmaki, Augustinas Sakinis, Olof Ehn, Gudmundur Johannsson, Oskar Ragnarsson
PURPOSE: Primary aldosteronism (PA) is a common cause of secondary hypertension. Adrenal venous sampling (AVS) is the gold standard for assessing laterality of PA, which is of paramount importance to decide adequate treatment. AVS is a technically complicated procedure with success rates ranging between 30% and 96%. The aim of this study was to investigate the success rate of AVS over time, performed by a single interventionalist. METHODS: This was a retrospective study based on consecutive AVS procedures performed by a single operator between September 2005 and June 2016...
February 21, 2018: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/29465715/application-of-strict-criteria-in-adrenal-venous-sampling-increases-the-proportion-of-missed-patients-with-unilateral-disease-who-benefit-from-surgery-for-primary-aldosteronism
#6
Gregory Kline, Alexander Leung, Benny So, Alex Chin, Adrian Harvey, Janice L Pasieka
OBJECTIVES: Adrenal vein sampling (AVS) is intended to confirm unilateral forms of primary aldosteronism, which are amenable to surgical cure. Excessively strict AVS criteria to define lateralization may result in many patients incorrectly categorized as bilateral primary aldosteronism and opportunity for surgical cure missed. METHODS: Retrospective review of an AVS-primary aldosteronism database in which surgical cases are verified by standardized outcomes. Having used 'less strict' AVS criteria for lateralization, we examined the distribution of AVS lateralization indices in our confirmed unilateral primary aldosteronism cases both with and without cosyntropin stimulation...
February 20, 2018: Journal of Hypertension
https://www.readbyqxmd.com/read/29464741/accuracy-of-adrenal-computed-tomography-in-predicting-the-unilateral-subtype-in-young-patients-with-hypokalaemia-and-elevation-of-aldosterone-in-primary-aldosteronism
#7
Hironobu Umakoshi, Tatsuki Ogasawara, Yoshiyu Takeda, Isao Kurihara, Hiroshi Itoh, Takuyuki Katabami, Takamasa Ichijo, Norio Wada, Yui Shibayama, Takanobu Yoshimoto, Yoshihiro Ogawa, Junji Kawashima, Masakatsu Sone, Nobuya Inagaki, Katsutoshi Takahashi, Minemori Watanabe, Yuichi Matsuda, Hiroki Kobayashi, Hirotaka Shibata, Kohei Kamemura, Michio Otsuki, Yuichi Fujii, Koichi Yamamto, Atsushi Ogo, Toshihiko Yanase, Shintaro Okamura, Shozo Miyauchi, Tomoko Suzuki, Mika Tsuiki, Mitsuhide Naruse
CONTEXT: The current Endocrine Society Guideline suggests that patients aged <35 years with marked primary aldosteronism (PA) and unilateral adrenal lesions on adrenal computed tomography (CT) scan may not need adrenal vein sampling (AVS) before proceeding to unilateral adrenalectomy. This suggestion is, however, based on the data from only one report in the literature. OBJECTIVE: We sought to determine the accuracy of CT findings in young PA patients who had unilateral adrenal disease on CT with hypokalaemia and elevation of aldosterone...
February 21, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29453922/a-short-review-of-primary-aldosteronism-in-a-question-and-answer-fashion
#8
Frederick-Anthony Farrugia, Nicolaos Zavras, Georgios Martikos, Panagiotis Tzanetis, Anestis Charalampopoulos, Evangelos P Misiakos, Dimitrios Sotiropoulos, Nikolaos Koliakos
OBJECTIVES: The aim of this study was to present up to date information concerning the diagnosis and treatment of primary aldosteronism (PA). PA is the most common cause of endocrine hypertension. It has been reported up to 24% of selective referred hypertensive patients. METHODS: We did a search in Pub-Med and Google Scholar using the terms: PA, hyperaldosteronism, idiopathic adrenal hyperplasia, diagnosis of PA, mineralocorticoid receptor antagonists, adrenalectomy, and surgery...
January 1, 2018: Endocrine Regulations
https://www.readbyqxmd.com/read/29422627/the-influence-of-the-peripheral-cortisol-fluctuation-on-the-success-rate-of-adrenal-venous-sampling
#9
Chin-Chen Chang, Bo-Ching Lee, Kao-Lang Liu, Yeun-Chung Chang, Vin-Cent Wu, Kuo-How Huang, Tung-Hsin Wu
In this retrospective study, we aimed to estimate the influence of fluctuating peripheral plasma cortisol concentration (PCC) on the success rate of non-stimulated adrenal venous sampling (AVS) and to demonstrate its fluctuating pattern. Overall, 107 consecutive patients with primary aldosteronism undergoing AVS between July 2015-January 2017 were included. The peripheral vein was sampled at 4 separate time points during the procedure: after femoral puncture, during left adrenal sampling, during right adrenal sampling, and before procedural ending...
February 8, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29409357/macrolides-for-kcnj5-mutated-aldosterone-producing-adenoma-mapa-design-of-a-study-for-personalized-diagnosis-of-primary-aldosteronism
#10
Giuseppe Maiolino, Giulio Ceolotto, Michele Battistel, Giulio Barbiero, Maurizio Cesari, Laurence Amar, Brasilina Caroccia, Roberto Padrini, Michel Azizi, Gian Paolo Rossi
PURPOSE: Aldosterone-producing adenoma (APA) is the main curable cause of endocrine hypertension cause of primary aldosteronism (PA) and it is in up to 66% of all cases investigated with adrenal vein sampling (AVS). Mutations in the KCNJ5 potassium channel involve up to 70% of APA and cause the most florid PA phenotypes. The recent finding that macrolide antibiotics specifically inhibit in vitro the altered function of mutated KCNJ5 channels has opened new horizons for the diagnosis and treatment of APA with KCNJ5 mutations in that it can allow identification and target treatment of PA patients harbouring a mutated APA...
February 6, 2018: Blood Pressure
https://www.readbyqxmd.com/read/29388434/annals-express-improved-technical-success-and-radiation-safety-of-adrenal-vein-sampling-using-rapid-semi-quantitative-point-of-care-cortisol-measurement
#11
Michael M Page, Mario Taranto, Duncan Ramsay, Greg van Schie, Paul Glendenning, Melissa Gillett, Samuel Vasikaran
OBJECTIVE: Primary aldosteronism is a curable cause of hypertension which can be treated surgically or medically depending on the findings of adrenal vein sampling (AVS) studies. AVS studies are technically demanding with a high failure rate in many centres. The use of intra-procedural cortisol measurement could improve the success rates of AVS but may be impracticable due to cost and effects on procedural duration. DESIGN: Retrospective review of the results of AVS procedures since commencement of point of care cortisol measurement using a novel single-use semi-quantitative measuring device for cortisol, the AVS Accuracy Kit (AAK)...
January 1, 2018: Annals of Clinical Biochemistry
https://www.readbyqxmd.com/read/29378066/technical-note-free-and-bound-cortisol-in-plasma-and-saliva-during-acth-challenge-in-dairy-cows-and-horses
#12
A-C Schwinn, F Sauer, V Gerber, R M Bruckmaier, J J Gross
Cortisol levels reflect hypothalamic-pituitary-adrenocortical (HPA) axis activity. While most plasma cortisol is supposed to be bound to the soluble cortisol binding globulin (CBG), only free cortisol (FC) actively regulates metabolic and immunological processes. We aimed to establish a multi-species suitable method to assess FC in cows and horses which in combination with total cortisol (TC) allows interpreting proportional changes of cortisol in saliva as well as in blood in response to a standardized HPA axis activation via ACTH...
January 25, 2018: Journal of Animal Science
https://www.readbyqxmd.com/read/29366348/case-report-an-identical-twin-with-sertoli-leydig-cell-tumor
#13
Kristy Cho, Jon C Havelock, Blake Gilks, Caitlin Dunne
Our report details the workup and management of a 43-year-old woman with an identical twin who presented with 2 years of virilization and secondary amenorrhea. Serum total testosterone was elevated. An MRI did not identify adnexal or adrenal pathology. Subsequent ovarian vein sampling demonstrated unilateral testosterone elevation. The patient underwent laparoscopic unilateral oophorectomy resulting in the diagnosis of Sertoli-Leydig cell tumor (SLCT). Although SLCT is a rare sex-cord ovarian tumor, it is associated with endometrial hyperplasia and malignancy...
January 24, 2018: Gynecological Endocrinology
https://www.readbyqxmd.com/read/29357735/niche-point-of-care-endocrine-testing-reviews-of-intraoperative-parathyroid-hormone-and-cortisol-monitoring
#14
Li-Sheng Chen, Ravinder J Singh
Point-of-care (POC) testing, which provides quick test results in near-patient settings with easy-to-use devices, has grown continually in recent decades. Among near-patient and on-site tests, rapid intraoperative and intra-procedural assays are used to quickly deliver critical information and thereby improve patient outcomes. Rapid intraoperative parathyroid hormone (ioPTH) monitoring measures postoperative reduction of parathyroid hormone (PTH) to predict surgical outcome in patients with primary hyperparathyroidism, and therefore contributes to the change of parathyroidectomy to a minimally invasive procedure...
March 2018: Critical Reviews in Clinical Laboratory Sciences
https://www.readbyqxmd.com/read/29238437/persistent-primary-aldosteronism-despite-iatrogenic-adrenal-hemorrhage-after-adrenal-vein-sampling
#15
Keisuke Okamura, Tetsu Okuda, Kazuyuki Shirai, Ichiro Abe, Kunihisa Kobayashi, Tatsu Ishii, Seiji Haraoka, Hidenori Urata
Before surgery for primary aldosteronism (PA), localization is evaluated with adrenal vein sampling (AVS). A 56-year-old Japanese woman had a right adrenal mass, hypokalemia, and a high aldosterone/renin ratio. Stress tests confirmed the diagnosis of PA. Subsequently, preoperative AVS was performed and right adrenal hemorrhage (AH) occurred unexpectedly. Because hypertension persisted, laparoscopic right adrenalectomy was performed. Postoperatively, the blood pressure was normalized. Pathological examination revealed an adrenal cortical adenoma largely unaffected by necrosis and hemorrhage...
January 2018: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/29229748/adrenal-vein-sampling-is-the-preferred-method-to-select-patients-with-primary-aldosteronism-for-adrenalectomy-con-side-of-the-argument
#16
RANDOMIZED CONTROLLED TRIAL
Jaap Deinum, Aleksander Prejbisz, Jacques W M Lenders, Gert Jan van der Wilt
No abstract text is available yet for this article.
January 2018: Hypertension
https://www.readbyqxmd.com/read/29229742/adrenal-vein-sampling-is-the-preferred-method-to-select-patients-with-primary-aldosteronism-for-adrenalectomy-pro-side-of-the-argument
#17
Gian Paolo Rossi, John W Funder
No abstract text is available yet for this article.
January 2018: Hypertension
https://www.readbyqxmd.com/read/29198769/subtyping-of-primary-aldosteronism-with-adrenal-vein-sampling-hormone-and-side-specific-effects-of-cosyntropin-and-metoclopramide
#18
Giacomo Rossitto, Giuseppe Maiolino, Livia Lenzini, Valeria Bisogni, Teresa Maria Seccia, Maurizio Cesari, Maurizio Iacobone, Gian Paolo Rossi
BACKGROUND: Cosyntropin and metoclopramide can affect the subtyping of primary aldosteronism when used with adrenal vein sampling by exerting hormone- and side-specific effects on cortisol and aldosterone secretion. We investigated how these stimuli affect the selectivity index, the relative aldosterone secretion index, and the lateralization index in consecutive primary aldosteronism patients submitted to adrenal vein sampling. METHODS: We recruited 171 patients; of these, 149 underwent adrenal vein sampling before and after stimulation with cosyntropin (250 µg intravenous bolus, n= 53, 73% with an aldosterone-producing adenoma) or with metoclopramide (10 mg intravenous bolus, n= 96, 65% aldosterone-producing adenoma), and 32 with an aldosterone-producing adenoma were investigated for the relative gene expression of dopamine, melanocortin 2, and 5-hydroxytryptamine (serotonin) 4 receptor with microarrays...
November 30, 2017: Surgery
https://www.readbyqxmd.com/read/29176594/subtype-prediction-of-primary-aldosteronism-by-combining-aldosterone-concentrations-in-the-left-adrenal-vein-and-inferior-vena-cava-a-multicenter-collaborative-study-on-adrenal-venous-sampling
#19
Yuichi Fujii, Hironobu Umakoshi, Norio Wada, Takamasa Ichijo, Kohei Kamemura, Yuichi Matsuda, Tatsuya Kai, Tomikazu Fukuoka, Ryuichi Sakamoto, Atsushi Ogo, Tomoko Suzuki, Kazutaka Nanba, Mika Tsuiki, Mitsuhide Naruse
Subtype diagnosis of primary aldosteronism (PA) by adrenal vein sampling (AVS) is recommended as a mandatory step for indicating adrenal surgery. It is a technically demanding procedure, especially in the right adrenal vein. The aim of the study was to predict the subtype diagnosis in the absence of values from the right AVS. From the databases of nine centers (WAVES-J), 308 patients with PA who underwent successful AVS were studied. Based on the ipsilateral ratio (IR) (aldosterone/cortisol ratio of the left adrenal vein [A/Cleft AV ] / aldosterone/cortisol ratio of the inferior vena cava [A/CIVC ]), the patients were divided into two groups: the patients with IR ≥ 1...
December 2017: Journal of Human Hypertension
https://www.readbyqxmd.com/read/29174432/primary-aldosteronism-making-sense-of-partial-data-sets-from-failed-adrenal-venous-sampling-suppression-of-adrenal-aldosterone-production-can-be-used-in-clinical-decision-making
#20
Veljko Strajina, Zahraa Al-Hilli, James C Andrews, Irina Bancos, Geoffrey B Thompson, David R Farley, Melanie L Lyden, Benzon M Dy, William F Young, Travis J McKenzie
BACKGROUND: It has been suggested that accurate clinical decisions may be made in patients with primary aldosteronism (PA) in the setting of failed cannulation of an adrenal vein, thereby utilizing only data from either right or left adrenal venous sampling (AVS) alone. METHODS: Retrospective analysis was performed for all patients with PA who underwent successful bilateral AVS. Adrenal vein/inferior vena cava index (AV/IVC index) was calculated by dividing aldosterone/cortisol ratio of the adrenal vein by aldosterone/cortisol ratio in the inferior vena cava, as described in a previously published study...
November 22, 2017: Surgery
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